Aerosol Composition for Administering Drugs

ABSTRACT

Described here are compositions and methods for the treatment of respiratory conditions using glucocorticosteroids delivered by a next generation nebulizer. The methods administer a therapeutic dose with nebulization time of 2 minutes or less. The faster nebulization time improves patient compliance.

CROSS REFERENCE TO RELATED CASES

This application claims the benefit of the U.S. Provisional Patent Application Ser. No. 61/403,941, filed on Sep. 22, 2010, the content of which is hereby incorporated by reference in its entirety.

TECHNICAL FIELD OF THE INVENTION

The compositions described herein are in the field of respiratory medicine. Specifically, compositions that allow for the administration of drug formulations by nebulization are described. More specifically, drug formulations that allow for the administration of glucocorticosteroids by next generation nebulizers are disclosed.

BACKGROUND OF THE INVENTION

Respiratory disorders are pulmonary conditions characterized by airway inflammation, airway hyperresponsiveness, and reversible airway obstruction. During respiratory disorder episodes, afflicted individuals often experience labored breathing, wheezing, and coughing. These symptoms may be treated by oral inhalation of medications such as beta adrenergic agonists or glucocorticosteroids, which for most patients can be administered via pressurized metered-dose inhalers (pMDIs) or dry powder inhalers (DPIs). However, certain patient populations, e.g., pediatric, neurologically impaired, severe asthmatics, or patients with COPD may lack the breath coordination needed for pMDIs or lack the lung capacity needed to use DPIs. Thus, patients suffering from respiratory disorders require the administration of therapy via nebulizers.

Drug formulations for oral delivery using nebulizers are aqueous solutions, dispersions or suspensions that are aerosolized then inhaled. The aerosol comprises very fine droplets of the formulation dispersed in air. The droplets are necessarily less than about 8 microns in diameter to enable delivery to the respiratory tract beyond the oropharynx upon inhalation. Aerosol generators, or nebulizers, apply mechanical shearing forces to the drug formulation by various means to break up the formulation surface or generate filament streams to form the droplets. Nebulizers typically use pneumatic, piezoelectric, ultrasonic, or electromechanical means to generate shearing forces. Some types of nebulizers rapidly vibrate a pool of the drug formulation to generate standing waves the tips of which breakup into fine droplets. Other types of nebulizers force the drug formulation through small apertures to generate streams of the drug formulation which breakup into fine droplets. A particular group of nebulizers, referred to herein as next generation nebulizers, use meshes or membranes, hereafter referred to as meshes. The meshes containing many apertures or pores having diameters typically between 1 and 8 microns. The drug formulation is forced through the mesh apertures by piezoelectric or electromechanical “pumping”, or alternatively, the mesh is vibrated to reciprocate through a pool of the formulation, to generate multiple liquid filaments with diameters approximating the mesh apertures. The filaments breakup to form droplets with diameters approximating the diameters of mesh apertures. These next generation nebulizers, which include but are not limited to the Aradigm's AerX and Essence, PARI's eFlow, Odom or TPP's TouchSpray, Respironics' Ineb and Myneb, Omron's MicroAir and Aerogen's Aeroneb, have proven to be very efficient and thus minimizing time to delivery. These next generation nebulizers can form aerosols which have a high proportion of respirable aerosol droplets which can be delivered to the respiratory tract.

The nebulizers may also incorporate baffling mechanisms to remove larger, nonrespirable droplets from the aerosol. In use, the nebulized formulation is administered to the individual via a mouthpiece or mask.

Low patient compliance is a generally known problem with nebulized drugs. This is primarily due to the amount of time required to nebulizer sufficient drug to deliver a therapeutic dose. Nebulization time can last up to 30 minutes, depending on such factors as the type of nebulizer, the volume of liquid formulation to be nebulized, the particular drug being nebulized and whether it is dissolved or suspended, the concentration of the drug in the formulation, the surface tension and viscosity of the formulation. A further complication arises if the drug is a dispersion or suspension formulation: the volumetric delivery rate may be constant, but the delivery of the drug is often not constant over time, with water enriched droplets at the beginning of the nebulization and drug rich droplets being delivered near the end of the recommended nebulization time. Thus, most of the therapeutic dose is delivered later in the nebulization time and early termination of treatment can result in a disproportionally decreased delivery of drug. This can lead to further non-compliance since the inadequate dose will likely fail to provide adequate therapy, and thus discourage further use of the nebulizer treatment regimen. Children and adults who become impatient because of lengthy nebulization times typically stop treatment prematurely, failing to achieve a therapeutic dose.

Use of next generation nebulizers to deliver a suspension-based medicament presents significant pharmaceutical formulation challenges in regard to the need to enhance both delivery efficiency to the lungs and drug residence time in the lungs. The first challenge is the efficient delivery of the drug particles to the lung. This is primarily determined by the size of the aerosol droplet. In order to penetrate into the lungs, the mean diameter of the aerosol droplet size distribution generated by the nebulizer should be between about 1 micron to about 4 microns, preferably between about 1 micron to about 3 microns. Further, the drug particles need to be smaller than about 4 microns in order to be carried by the droplet aerosol into the lungs. The drug particles in the aerosol suspension (aerosol droplet) must be able to pass through the small aperatures of the nebulizer mesh/membrane in an efficient and reproducible manner.

Existing nebulizers often retain a large percentage of the drug within device at the end of the delivery. This is especially true of suspensions when the formulation has drug particles larger than about 5 micron (e.g. Astra Zeneca's Pulmicort® or Teva's Budesonide Inhalation Suspension. Chiesi's Beclomethasone, or GlaxoSmithKline's Flutide) and is delivered by a next generation nebulizer (e.g. Aerogen's Aeroneb Go, PARI's eFlow, Omron's MicroAir, or Respironic's Ineb). Because the particles are too large to easily pass through the mesh, a majority of the particles, can be retained in the device. High drug particle retention is undesirable because the particles block the flow of the formulation through the mesh which decreases delivery rate resulting in increased delivery time. High drug retention also lowers delivery efficiency, e.g., more drug has to be loaded into the device to achieve a particular delivered dose. This increases the cost of the drug. Even worse, the retained drug particles can mechanically interfere with operation of the next generation nebulizer by accumulating in the mesh, clogging the pores and eventually blocking drug output, disabling the nebulizer.

A second challenge is achieving appropriate drug residence time in the lungs. Delivery of the drug to the lungs by itself is not sufficient to achieve treatment if the drug passes immediately through the lung to systemic circulation. Hockhaus, G. (2007) Annals of Allergy, Asthma and Immunology 98:S7-15. Prolonging the residence time in the lung will increase pulmonary receptor selectivity to treat local inflammation and lower undesirable systemic receptor side effects such as endogenous hormone generation and resulting growth suppression. Suarez et al., (1998) Pharm Res. 15:461-465. However, increased residence time can also result in increased systemic absorption and circulation. One way to increase drug residence time is to increase the size of the delivered drug particles, but this is in direct conflict with reducing the drug particle size to enable nebulizing with a next generation mesh/membrane nebulizer. Increases in the particle size that result in a particle dimension approaching or exceeding the size of the apertures in the mesh/membrane will reduce delivery efficiency. Decreases in the particle size, such as molecular-complex solutions, submicron or nanometer particle size suspensions to accommodate passage through the mesh/membrane will markedly decrease particle residence time in the lungs.

Consequently, new formulations and methods for administering suspended nebulized drugs are needed that would shorten delivery times and minimize drug retention in the device to maximize compliance and therapeutic efficacy. Specifically, administration methods having nebulization times with less than 120 seconds to achieve a therapeutic dose would be desirable to improve patient compliance. In addition, formulations and methods which achieve a retention of 40% or less of the suspended drug particles in the device would ensure efficient delivery of the therapeutic dose, use less drug and provide for greater mechanical reliability of the next generation nebulizers.

SUMMARY OF THE INVENTION

Described herein are formulations and methods for the treatment of respiratory disorders using drugs delivered by a next generation nebulizer. In particular, formulations and compositions provide a glucocorticosteroid that can be administered through a next generation nebulizer to a patient or subject needing such treatment, wherein such treatment is administered in less than 120 seconds or less.

Furthermore, the formulations are aqueous dispersions or suspensions of particles of drug, such as glucocorticosteroids, in the size range of about 1 micron to about 3 microns and 40% or less of the particles are retained on the mesh of a next generation nebulizer after a dose is delivered. In some embodiments, the fine particle fraction (FPF) of the drug-containing aerosol (as measured by compendial method USP601) generated by a next generation nebulizer is at least about 25%.

The invention also provides an aqueous dispersion or suspension of a drug such that, when a therapeutic dose of the drug is administered by a next generation nebulizer to generate an inhaled aerosol composition, the aerosol composition comprises drug particles having a mean diameter from about 1 micron to about 3 microns. The aerosol composition itself has a fine particle fraction of at least about 25% and the nebulatization time of the therapeutic dose is in the range of about 15 seconds to about 120 seconds and about 39% or less of the drug particles are retained on the mesh after nebulization. In some embodiments, the drug has a concentration from about 0.01 miligrams/milliliter to about 50 milligrams/milliliter. In some embodiments, the aqueous dispersion or suspension of the drug further comprises a dispersion enhancer in a concentration from about 0.001 w/w % to about 10 w/w %. In some embodiments, the drug comprises a compound selected from the group consisting of 21-acetoxypregnenolone, alclometasone, algestone, amcinonide, beclomethasone, betamethasone, budesonide, chloroprednisone, ciclesonide, clobetasol, clobetasone, clocortolone, cloprednol, corticosterone, cortisone, cortivazol, deflazacort, desciclesonide, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difluprednate, enoxolone, fluazacort, flucloronide, flumethasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, fluticasone propionate, formocortal, halcinonide, halobetasol propionate, halometasone, halopredone acetate, hydrocortamate, hydrocortisone, loteprednol etabonate, mazipredone, medrysone, meprednisone, methylprednisolone, mometasone furoate, paramethasone, prednicarbate, prednisolone, prednisolone 25-diethylamino-acetate, prednisolone sodium phosphate, prednisone, prednival, prednylidene, rimexolone, tixocortol, triamcinolone, triamcinolone acetonide, triamcinolone benetonide, triamcinolone hexacetonide, (11b,16a)-16,17-[butylidenebisbis(oxy)]-11,21-dihydroxy-16-methylpregna-1,4-diene-3,20-dione 21-[(4′-nitrooxymethyl)benzoate] and derivatives, analogues, enantiomer forms, stereoisomers, anhydrides, acid addition salts, base salts, solvates, and combinations thereof. In other embodiments, the drug is an aqueous dispersion or suspension of budesonide. In some embodiments, the dispersion enhancer is selected from the group consisting of polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80, lecithin, polyethylene glycol, polyvinylpyrrolidone and poloxamer. In one aspect, the dispersion enhancer is polysorbate 80, present in a concentration in the range of about 50 micrograms per milliliter to about 200 micrograms per milliliter. In another aspect, the dispersion enhancer is polysorbate 80, present in a concentration in the range of about 100 micrograms per milliliter to about 200 micrograms per milliliter. In still another aspect, the dispersion enhancer is polysorbate 80, present in a concentration in the range of about 120 micrograms per milliliter to about 130 micrograms per milliliter. In another aspect, the nebulization time for administering the therapeutic dose is about 60 seconds or less. In some embodiments, the drug is present at a concentration of about 0.2 milligrams per milliliter.

The invention also provides for a therapeutic dose comprising an aqueous dispersion or suspension of budesonide particles, wherein the aqueous dispersion or suspension comprises polysorbate 80 at a concentration in the range of about 120 micrograms per milliliter to about 130 micrograms per milliliter; the budesonide particles having a mean diameter from about 1 micron to about 3 microns; the therapeutic dose is administered by a next generation nebulizer to generate an inhaled aerosol composition; wherein the aerosol composition has a fine particle fraction of at least 25%, and the therapeutic dose can be administered in a period of about 15 seconds to about 120 seconds; and wherein 29% or less of the budesonide particles are retained on the mesh of the nebulizer after administration of the dose. In one aspect, the therapeutic dose comprises budesonide particles having a mean diameter of about 1.5 microns to about 2.5 microns. In another aspect, the aerosol composition has a particle size that is about 5.0 microns or less.

The invention also provides for a method of treating a patient having a respiratory disorder comprising the steps of: forming an aerosol composition by introducing into a next generation nebulizer a predetermined volume of a drug formulation comprising a dispersion or suspension of glucocorticosteroid particles; the aerosol composition comprising a dispersion enhancer; the glucocorticosteroid particles having a mean diameter from about 1 micron to about 3 microns; the aerosol composition having a fine particle fraction of at least 25%; the predetermined volume of the dispersion or suspension of glucocorticosteroids is delivered by the next generation nebulizer in about 120 seconds or less and wherein 40% or less of the aerosol composition is retained on the mesh after the predetermined volume has been delivered. In one aspect, the glucocorticosteroid is budesonide. In another aspect, the dispersion enhancer is polysorbate 80. In another aspect, the predetermined volume of the dispersion or suspension of glucocorticosteroids is delivered by the next generation nebulizer in about 60 seconds or less. In still another aspect, the budesonide is present in the formulation at a concentration in the range of about 0.03 milligrams per milliliter to about 2.0 milligrams per milliliter. In another aspect, the dispersion enhancer is polysorbate 80, present in the range of about 120 micrograms per milliliter to about 130 micrograms per milliliter. In another aspect, the predetermined volume of the dispersion or suspension of glucocorticosteroids is delivered by the next generation of nebulizer in about 30 seconds or less.

DETAILED DESCRIPTION OF THE INVENTION

This detailed description of the invention is divided into sections for the convenience of the reader. Section I provides definitions of terms used herein. Section II provides a description of methods for treating respiratory disorders. Section III provides a description of formulations that are useful for use in the invention. Section IV discloses examples that illustrate various aspects and embodiments of the invention.

I. Definitions

Unless defined otherwise, all technical and scientific terms used herein have the meaning commonly understood by a person skilled in the art to which this invention belongs. As used herein, the following terms have the meanings ascribed to them unless specified otherwise.

“Nebulization time” refers to the time needed to deliver a therapeutic dose of the drug formulation. A non-limiting example of such drug formulation is a glucocorticosteroid dispersion or suspension.

“Dispersion enhancer” refers to an excipient which reduces, minimizes or eliminates aggregation or agglomeration of particles of a drug.

“Treatment” or “treating” refers to the amelioration, reduction or prevention of symptoms indicative of a respiratory disorder.

“Next generation nebulizer” refers to a nebulizer using a mesh or membrane with an array of pores or apertures. The nebulizer generates an aerosol either by vibrating the mesh or membrane, thus forcing the drug formulation through the mesh or membrane. Non-limiting examples of next generation nebulizers include, Aradigm's AerX and Essence, PARI's eFlow, Odom or TPP's TouchSpray, Respironics' Ineb and Myneb, Omron's MicroAir series and Aerogen's Aeroneb series of aerosol generators.

II. Methods for Treating Respiratory Disorders

Described herein are formulations and methods for treatment of respiratory disorders using glucocorticosteroid dispersions or suspensions comprised of about 1 to about 5 micron drug particles delivered via a next generation nebulizer. The methods administer a dose of glucocorticosteroid with nebulization times that are faster than commercially available formulations. For example, nebulization times may be about 5 minutes or less, about 3.0 minutes or less, about 2.0 minutes (or 120 seconds) or less, or about 1 minute (or 60 seconds) or less. This administration regimen is more convenient for the patient, and thus, may improve patient compliance. A the end of the nebulization times, less than 40% of the drug particles are retained on the mesh or membrane of the next generation nebulizer. In addition, the fine particle fraction (FPF) of the drug containing aerosol delivered from the next generation nebulizer is at least 25%.

In one embodiment of the invention, the formulation would include a glucocorticosteroid having a concentration of 0.01 milligrams/milliliter to about 50 milligrams/milliliter. In another embodiment, the glucocorticosteroid is at a concentration of 0.01 milligrams/milliliter to about 20 milligrams/milliliter. In yet another embodiment, the glucocorticosteroid is at a concentration of 0.01 milligrams/milliliter to about 5 milligrams/milliliter. In still another embodiment, the glucocorticosteroid is at a concentration range of about 0.03 milligrams/milliliter to about 2 milligrams/milliliter. The glucocorticosteroid may be provided in a formulation that also includes a dispersion enhancer, a chemical stabilizer, buffers and/or other excipients.

The methods described herein administer a glucocorticosteroid at least once a day. However, glucocorticosteroid administration may be repeated or administered more frequently. For example, the glucocorticosteroid may be administered one to four times a day or additionally as needed. Scheduling may also be varied. Variations in the number of doses administered per day can be varied as dictated by the needs of the patient.

The dose of glucocorticosteroid may also vary, but will generally be a low dose. In one embodiment, the dose of budesonide that is administered may be less than about 0.30 milligrams. In another embodiment, the budesonide dose is between about 0.03 milligrams to about 2 milligrams. In another embodiment, the budesonide dose is between about 0.10 milligrams to about 0.50 milligrams. In other embodiments, the dose of budesonide administered is about 0.25 milligrams or less. In still further embodiments, the dose of budesonide administered is about 0.125 milligrams or less and in another embodiment the dose of budesonide administered is about 0.0625 or less.

The respiratory disorders that may be treated with the methods described herein without limitation, include asthma, chronic obstructive pulmonary disease (COPD), emphysema, bronchitis, bronchiolitis, pneumonia, neoplasms of the large and small airways, and respiratory distress syndrome. The patients that may be treated can be of any age, ranging from neonates, infants, children, and adolescents, adults and the elderly. The methods may also be useful in adults.

III. Formulations

Suitable glucocorticosteroids that may be employed in compositions of the present invention include, but are not limited to, 21-acetoxypregnenolone, alclometasone, algestone, amcinonide, beclomethasone, betamethasone, budesonide, chloroprednisone, ciclesonide, clobetasol, clobetasone, clocortolone, cloprednol, corticosterone, cortisone, cortivazol, deflazacort, desciclesonide, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difluprednate, enoxolone, fluazacort, flucloronide, flumethasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, fluticasone propionate, formocortal, halcinonide, halobetasol propionate, halometasone, halopredone acetate, hydrocortamate, hydrocortisone, loteprednol etabonate, mazipredone, medrysone, meprednisone, methylprednisolone, mometasone furoate, paramethasone, prednicarbate, prednisolone, prednisolone 25-diethylamino-acetate, prednisolone sodium phosphate, prednisone, prednival, prednylidene, rimexolone, tixocortol, triamcinolone, triamcinolone acetonide, triamcinolone benetonide, triamcinolone hexacetonide, (11b,16a)-16,17-[butylidenebisbis(oxy)]-11,21-dihydroxy-16-methylpregna-1,4-diene-3,20-dione 21-[(4′-nitrooxymethyl)benzoate] and derivatives, analogues, enantiomer forms, stereoisomers, anhydrides, acid addition salts, base salts, solvates, and combinations thereof. In one variation, the glucocorticosteroid is budesonide.

Drug particles that are used in the formulations are in the size range of about 1 micron to about 5 microns. With the preferable size range being about 1 micron to about 2 microns. When dispersed or suspended in the formulation, the volume median diameter (VMD), when measured by laser diffraction (Sympatec Helos/BF), is in the range of about 1 to about 8 microns.

The formulations of the present invention contain a single dispersion enhancer which could include polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80, lecithin, polyethylene glycols, polyvinylpyrolidones, or poloxamers, with Polysorbate 80 being the preferred dispersion enhancer.

Other excipients that may be used, include, but are not limited to, one or more inclusion complexes, pH buffers, tonicity modifiers, viscosity and surface tension modifiers, suspending agents, preservatives, physicochemical stabilizers.

IV. EXAMPLES

Exemplary compositions of the present invention include budesonide, a dispersion enhancer, a chemical stabilizer, isotonicity and buffering agents, and water for injection to make the desired final concentration.

Exemplary Budesonide Formulation

Component Concentration Budesonide 200 μg/ml Polysorbate 80 125 μg/ml NaCl 8.5 mg/ml EDTA 50 μg/ml (Edetate Disodium Dihydrate) Sodium Citrate Dihydrate 0.624 mg/ml Citric Acid 0.188 mg/ml Water for Injection q.s. to 0.5 ml

When 0.5 milliliters of the Exemplary Budesonide Formulation were introduced into an AeroNeb Go next generation nebulizer, approximately 95% of this volume was consumed and delivered by the next generation nebulizer in about 60 seconds. The in-vitro aerosol performance was measured with a Next Generation Impactor (“NGI”, Applied Physics, Inc. PO Box 549, Niwot, Colo. 80544 USA) with a flow rate of 15 L/min according to USP Chapter 601. The two formulations are identical except for particle size which is noted for each formulation.

FORMULATION #1 Mean (n = 3) Nebulization Time (seconds) 59 Fill Volume (mL) 0.49 Nebulized Volume (mL) 0.44 Loaded Dose (μg) 99 Total Recovery (μg) 88 Emitted Dose (μg) 55 Residual Dose (μg; retained on mesh) 12 Residual Dose (% of total drug retained on mesh) 13.8 FPD ≦4.7 μm (μg) 19 FPF ≦4.7 μm (%) 33.8 MMAD (μm) 6.1 GSD 2.1 Budesonide particle mean diameter (by SEM): about 1.5 μm Formulation particle size (VMD by laser diffraction): 2.8 μm

FORMULATION #2 Mean (n = 3) Nebulization Time (seconds) 56 Fill Volume (mL) 0.49 Nebulized Volume (mL) 0.42 Loaded Dose (μg) 92 Total Recovery (μg) 78 Emitted Dose (μg) 40 Residual Dose (μg; retained on mesh) 18 Residual Dose (% of total drug retained on mesh) 22.8 FPD ≦4.7 μm (μg) 12 FPF ≦4.7 μm (%) 30.8 MMAD (μm) 6.3 GSD 2.0 Budesonide particle mean diameter (by SEM): about 2.5 μm Formulation particle size (VMD by laser diffraction): 5.0 μm Pulmicort ® Respules (0.5 mg/2 ml strength) Mean (n = 3) Nebulization Time (seconds) 70 Fill Volume (mL) 0.49 Nebulized Volume 0.46 Loaded Dose (μg) 122 Total Recovery (μg) 107 Emitted Dose (μg) 46 Residual Dose (μg; retained on mesh) 52 Residual Dose (% of total drug retained on mesh) 48.3 FPD ≦4.7 μm (μg) 24 FPF ≦4.7 μm (%) 51.2 MMAD (μm) 4.5 GSD 1.8 Budesonide particle mean diameter (by SEM): 2.2~2.9 μm Formulation particle size (VMD by laser diffraction): 9.6 μm

The two formulations of the invention are compared with Pulmicort® Respules.

Mean Nebulization diameter of Retained time budesonide VMD * on Mesh (Seconds, Formulation particles (n = 3) (%, n = 3) n = 3) Pulmicort ® Respules   2.2~2.9 μm 9.6 μm 48.3 70 (0.5 mg/2 ml) Formulation #1 about 1.5 μm 2.8 μm 13.8 59 Formulation #2 about 2.5 μm 5.0 μm 22.8 56 * VMD was measure by laser diffraction on a Sympatec HELOS/BF. A 50 milliliter cuvette was used with an R3 lens. 1200 rpm stirring was applied during test. No sonication was applied. The measurement duration was 5 seconds with time base of 50 milliseconds.

While certain embodiments have been described herein, it will be understood by one skilled in the art that the compositions and methods of the present disclosure may be embodied in other specific forms without departing from the spirit thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive of the present disclosure. Rather, the scope and spirit of the present invention is embodied by the appended claims. 

What is claimed is:
 1. An aqueous dispersion or suspension of a drug wherein when a therapeutic dose is administered by a next generation nebulizer to generate an inhaled aerosol composition: said aerosol composition comprises drug particles having a mean diameter from about 1 micron to about 3 microns; said aerosol composition has a fine particle fraction of at least about 25%; the nebulization time is in the range of about 15 seconds to about 120 seconds; and about 39% or less of the drug particles are retained on the mesh after the nebulization time.
 2. An aqueous dispersion or suspension of a drug as described in claim 1 wherein said drug has a concentration from about 0.01 milligrams/milliliter to about 50 milligrams/milliliter.
 3. An aqueous dispersion or suspension of a drug as described in claim 1 further comprising a dispersion enhancer in a concentration from about 0.001 w/w % to about 10 w/w %.
 4. An aqueous dispersion or suspension of a drug as described in claim 1 wherein said drug comprises a compound selected from the group consisting of 21-acetoxypregnenolone, alclometasone, algestone, amcinonide, beclomethasone, betamethasone, budesonide, chloroprednisone, ciclesonide, clobetasol, clobetasone, clocortolone, cloprednol, corticosterone, cortisone, cortivazol, deflazacort, desciclesonide, desonide, desoximetasone, dexamethasone, diflorasone, diflucortolone, difluprednate, enoxolone, fluazacort, flucloronide, flumethasone, flunisolide, fluocinolone acetonide, fluocinonide, fluocortin butyl, fluocortolone, fluorometholone, fluperolone acetate, fluprednidene acetate, fluprednisolone, flurandrenolide, fluticasone propionate, formocortal, halcinonide, halobetasol propionate, halometasone, halopredone acetate, hydrocortamate, hydrocortisone, loteprednol etabonate, mazipredone, medrysone, meprednisone, methylprednisolone, mometasone furoate, paramethasone, prednicarbate, prednisolone, prednisolone 25-diethylamino-acetate, prednisolone sodium phosphate, prednisone, prednival, prednylidene, rimexolone, tixocortol, triamcinolone, triamcinolone acetonide, triamcinolone benetonide, triamcinolone hexacetonide, (11b,16a)-16,17-[butylidenebisbis(oxy)]-11,21-dihydroxy-16-methylpregna-1,4-diene-3,20-dione 21-[(4′-nitrooxymethyl)benzoate] and derivatives, analogues, enantiomer forms, stereoisomers, anhydrides, acid addition salts, base salts, solvates, and combinations thereof.
 5. An aqueous dispersion or suspension of a drug as described in claim 1 wherein said drug is budesonide.
 6. An aqueous dispersion or suspension of a drug as described in claim 1 wherein said drug is selected from the group consisting of mometesone furoate, (11b,16a)-16,17-[butylidenebisbis(oxy)]-11,21-dihydroxy-16-methylpregna-1,4-diene-3,20-dione 21-[(4′-nitrooxymethyl)benzoate], and ciclesonide.
 7. An aqueous dispersion or suspension of a drug as described in claim 1 wherein said aerosol composition further comprises a dispersion enhancer selected from the group consisting of polysorbate 20, polysorbate 40, polysorbate 60, polysorbate 80, lecithin, polyethylene glycol, polyvinylpyrrolidone and poloxamer.
 8. An aqueous dispersion or suspension of a drug as described in claim 7 wherein the dispersion enhancer is polysorbate
 80. 9. An aqueous dispersion or suspension of a drug as described in claim 8 wherein said polysorbate 80 is present in a concentration in the range of about 50 micrograms per milliliter to about 200 micrograms per milliliter.
 10. An aqueous dispersion or suspension of a drug as described in claim 8 wherein said polysorbate 80 is present in a concentration in the range of about 100 micrograms per milliliter to about 200 micrograms per milliliter.
 11. An aqueous dispersion or suspension of a drug as described in claim 8 wherein said polysorbate 80 is present in a concentration in the range of about 120 micrograms per milliliter to about 130 micrograms per milliliter.
 12. An aqueous dispersion or suspension as described in claim 1, wherein the nebulization time for administering the therapeutic dose is about 60 seconds or less.
 13. An aqueous dispersion or suspension of a drug as described in claim 1 wherein said drug is present at a concentration of about 0.2 milligrams/milliliter.
 14. An aqueous dispersion or suspension of a drug as described in claim 1 wherein the aerosol composition has a fine particle fraction of least about 25%.
 15. A therapeutic dose comprising an aqueous dispersion or suspension of budesonide particles, wherein: said aqueous dispersion or suspension comprises polysorbate 80 at a concentration in range of about 120 micrograms per milliliter to about 130 micrograms per milliliter; said budesonide particles have a mean diameter from about 1 microns to about 3 microns; said therapeutic dose is administered by a next generation nebulizer to generate an inhaled aerosol composition; wherein said aerosol composition has a fine particle fraction is at least 25%; said therapeutic dose can be administered a period of about 15 seconds to about 120 seconds; and wherein 39% or less of the budesonide particles retained on the mesh of the nebulizer.
 16. The therapeutic dose of claim 15, wherein the budesonide particles have a mean diameter of about 1.5 microns to about 2.5 microns.
 17. The therapeutic dose of claim 15, wherein the aerosol composition has a particle size that is about 5.0 microns or less.
 18. A method of treating a patient having a respiratory disorder comprising the steps of: forming an aerosol composition by introducing into a next generation nebulizer a predetermined volume of a drug formulation comprising a dispersion or suspension of glucocorticosteroid particles; said aerosol composition comprising a dispersion enhancer; said glucocorticosteroid particles having a mean diameter from about 1 micron about 3 microns; and the said aerosol composition has a fine particle fraction is at least 25%; said predetermined volume of said dispersion or suspension of glucocorticosteroids is delivered by the next generation nebulizer in about 120 seconds or less; and wherein 40% or less of the therapeutic particles are retained on the mesh after predetermined volume has been delivered.
 19. A method of treating a patient having a respiratory disorder as described in claim 18 wherein said glucocorticosteroid is budesonide; said dispersion enhancer is polysorbate 80; and said predetermined volume of said dispersion or suspension of glucocorticosteroids is delivered by the next generation nebulizer in about 60 seconds or less.
 20. A method of treating a patient having a respiratory disorder as described in claim 19 wherein said budesonide is present in the formulation at concentration in the range of about 0.03 milligrams per milliliter to about 2.0 milligrams per milliliter; said polysorbate 80 is present in a range of about 120 micrograms per milliliter to about 130 micrograms per milliliter; and said predetermined volume of said dispersion or suspension of glucocorticosteroids is delivered by the next generation nebulizer in about 30 seconds or less. 